US8480750B2 - Modular glenoid prosthesis - Google Patents
Modular glenoid prosthesis Download PDFInfo
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- US8480750B2 US8480750B2 US12/953,522 US95352210A US8480750B2 US 8480750 B2 US8480750 B2 US 8480750B2 US 95352210 A US95352210 A US 95352210A US 8480750 B2 US8480750 B2 US 8480750B2
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- glenoid
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/40—Joints for shoulders
-
- A—HUMAN NECESSITIES
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/30721—Accessories
- A61F2/30734—Modular inserts, sleeves or augments, e.g. placed on proximal part of stem for fixation purposes or wedges for bridging a bone defect
-
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
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- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
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- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30383—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30383—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove
- A61F2002/30387—Dovetail connection
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
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- A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
- A61F2002/30383—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove
- A61F2002/3039—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by laterally inserting a protrusion, e.g. a rib into a complementarily-shaped groove with possibility of relative movement of the rib within the groove
- A61F2002/30398—Sliding
- A61F2002/304—Sliding with additional means for limiting said sliding
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30537—Special structural features of bone or joint prostheses not otherwise provided for adjustable
- A61F2002/30538—Special structural features of bone or joint prostheses not otherwise provided for adjustable for adjusting angular orientation
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- A—HUMAN NECESSITIES
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
- A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
- A61F2002/30604—Special structural features of bone or joint prostheses not otherwise provided for modular
-
- A—HUMAN NECESSITIES
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
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- A61F2/30734—Modular inserts, sleeves or augments, e.g. placed on proximal part of stem for fixation purposes or wedges for bridging a bone defect
- A61F2002/30736—Augments or augmentation pieces, e.g. wedges or blocks for bridging a bone defect
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- A—HUMAN NECESSITIES
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
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- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
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- Y10T29/00—Metal working
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Definitions
- the present invention relates to a prosthetic glenoid component and particularly to a modular glenoid assembly for attachment to a glenoid surface of a scapula to replace a natural socket of a shoulder and to provide a bearing surface for a head portion of an arm bone or humerus.
- a humeral component having a head portion is utilized to replace the natural head portion of the arm bone or humerus.
- the humeral component typically has an elongated intramedullary stem which is utilized to secure the humeral component to the patient's humerus.
- the natural glenoid surface of the scapula is resurfaced or otherwise replaced with a glenoid component which provides a bearing surface for the head portion of the humeral component.
- Glenoid components have heretofore been designed which include a number of plastic inserts coupled to metal backings.
- the metal backings are provided to secure the plastic inserts to the glenoid surface of the scapula.
- use of such two-piece glenoid components has a number of drawbacks associated therewith.
- wear of the plastic insert inherently occurs at the interface between plastic insert and the metal backing. It is possible for the plastic insert to wear to a degree which necessitates replacement of the glenoid component. It should be appreciated that in either case, such replacement of the glenoid component requires the patient to again be subjected to a surgical procedure and the subsequent recovery period associated therewith.
- a number of one-piece glenoid components have heretofore been designed.
- a body portion having a bearing surface defined therein for receiving the head of the humeral component, has a number of attachment pegs integrally formed therewith.
- the attachment pegs are advanced and thereafter secured into a corresponding number of holes which are drilled in the glenoid surface of the scapula by use of bone cement.
- An example of such a one-piece glenoid component that is designed to be secured to the scapula by use of bone cement is disclosed in U.S. Pat. No. 5,032,132 issued to Matsen, III et al.
- certain one-piece glenoid components which have heretofore been designed have a number of drawbacks associated therewith. For example, some studies have speculated that it may be desirable to secure artificial components to natural bone structures without the use of bone cement. Glenoid components which have been designed to be secured to the scapula by the use of bone cement generally cannot be secured to the natural glenoid without use of the same.
- glenoid component designs have been manufactured to address different types of scapular deficiencies.
- some glenoid components have anchor pegs with flexible fins that are designed to act as barbs when inserted into the scapula.
- Other designs may utilize glenoid components with a buttress extending from the glenoid to fill larger defects in the natural glenoid. These may also include anchor and/or stabilizing pegs.
- a vault-filling glenoid may be used to fill a natural glenoid that has severe defects.
- a stepped glenoid is provided to allow the surgeon to fill the eroded glenoid.
- these glenoids come in predetermined sizes and the size of the step (height and width) may not appropriately fill the glenoid erosion.
- a modular glenoid assembly includes a base having a first side and an opposing second side.
- the first side includes a plurality of connection features arranged in an array.
- the modular glenoid also includes at least one glenoid attachment member, the glenoid attachment member having a locking mechanism sized and shaped to lock the glenoid attachment member in at least one of the plurality of connection features on the base.
- a kit for use in a shoulder arthroplasty includes a modular glenoid assembly.
- the modular glenoid assembly includes a base having a first side and an opposing side. The first side includes a plurality of connection features arranged in an array.
- the modular glenoid assembly further including a glenoid attachment member selected from a plurality of glenoid attachment members.
- Each of the plurality of glenoid attachment members have a locking mechanism sized and shaped to connect the base with the glenoid attachment member.
- At least one of the plurality of glenoid attachment members has a shape different than at least one other of the plurality of glenoid attachment members and wherein the locking mechanism of each of the plurality of glenoid attachment members is the same.
- a method for assembling a glenoid assembly includes using a base having a first side and an opposing second side.
- the first side includes a plurality of connection features arranged in an array.
- the method further includes using a plurality of glenoid attachment members, each of the plurality of glenoid attachment members having a locking mechanism.
- One of the plurality of glenoid attachment members is selected.
- the base is connected to the selected one of the plurality of glenoid attachment members by connecting the locking mechanism of the selected one of the plurality of glenoid attachment members to one of the plurality of connection features of the base.
- FIG. 1 is a perspective view of a glenoid assembly according to one embodiment of the present invention.
- FIG. 2 is a side view of a base of the glenoid assembly of FIG. 1 .
- FIG. 3 is a perspective view of an offset of the glenoid assembly of FIG. 1 .
- FIG. 4 a is a side view of a cemented peg of the glenoid assembly of FIG. 1 .
- FIG. 4 b is a side view of an anchor peg of the glenoid assembly of FIG. 1 .
- FIG. 5 is a perspective view of the modular glenoid assembly of FIG. 1 positioned between a glenoid surface of a scapula and a humeral component.
- FIG. 6 is a perspective view of a glenoid assembly according to another embodiment of the present invention.
- FIG. 7 is a perspective view of a wedge-shaped filler of the glenoid assembly of FIG. 6 .
- FIG. 8 is a perspective view of a glenoid assembly according to another embodiment of the present invention.
- FIG. 9 is a perspective view of another glenoid assembly according to another embodiment of the present invention.
- FIG. 10 is a perspective view of an augment according to the glenoid assembly of FIG. 8 or 9 .
- FIG. 11 is an illustration showing a kit for making a modular glenoid assembly according to one embodiment of the present invention.
- FIG. 12 is a flow chart illustrating a method for assembling the modular glenoid assembly according to one embodiment of the present invention.
- FIG. 1 shows glenoid assembly 10 including a base 12 , an offset 14 , and a glenoid attachment member 16 .
- the base 12 includes a first side 18 and a second side 20 .
- the first side includes a plurality of connection features 22 arranged in an array.
- the second side 20 of the base 12 includes a locking feature 23 .
- the locking feature 23 is a pair of receptacles 24 .
- the offset 14 includes an articulation side 25 an opposing coupling side 26 .
- the articulation side 24 is sized and shaped to articulate with a humeral component (discussed further below with respect to FIG. 5 ).
- the opposing coupling side 26 includes a locking feature 28 .
- the locking feature 28 is a pair of protrusions 30 that lock into the receptacles 22 of the base 12 .
- other known locking features may be used, such as dovetails, and snap locks.
- the glenoid attachment member 16 includes a finned anchor peg 32 and a plurality of cemented pegs 34 .
- Each of the glenoid attachment members 16 include a locking mechanism 36 sized and shaped to lock the glenoid attachment member 16 into at least one of the plurality of connection features 22 on the base 12 .
- each of the finned anchor peg 32 and cemented pegs 34 have a locking mechanism 36 .
- the locking mechanism 36 is a ball-shaped member 38 and the connection features 22 are each generally spherical shaped receptacles 40 that are sized and shaped to lock the ball shaped member 38 into place.
- the generally spherical shaped receptacles are arranged in an array.
- each of the connection features is the same size, allowing for the user to place the glenoid attachment members 16 anywhere along the array. Giving the user this flexibility allows the user to select the best location for the attachment members 16 based upon bone stock or other considerations.
- the locking mechanism 36 and the connection features 22 are generally spherical (balls and receptacles respectively) the user may insert the finned anchor peg 32 and/or cemented pegs 34 at a variety of different angles.
- the locking mechanism 36 may be of a different size, so long as it is able to lock into the connection feature 22 .
- the finned anchor pegs 32 and cemented pegs 34 may be of different sizes and shapes.
- the glenoid assembly 10 is shown located between a glenoid surface 41 of a scapula 42 and a head portion 44 of a humeral component 46 .
- Glenoid assembly 10 is designed to be attached to glenoid surface 41 of scapula 42 to replace the natural glenoid surface.
- the finned anchor peg 32 and cemented pegs 34 correspond to holes 43 drilled into the glenoid surface 41 .
- the finned anchor peg 32 and cemented pegs 34 will be placed in the holes 44 , locking the glenoid assembly 10 to the glenoid surface 40 .
- the articulation side 24 of the offset 14 is smooth and will articulate with the head portion 44 of the humeral component 46 .
- the head portion 44 may also be an implant.
- the head portion 44 may be the natural humeral head.
- the base 12 may not need to be coupled to an offset and the second side 18 of the base 12 may be used to articulate directly with the head portion 44 of the humeral component. In those embodiments, the base 12 may not include the locking feature 23 described above.
- the base 12 is illustrated coupled to the offset 14 and the glenoid attachment member 16 .
- the glenoid attachment member 16 is a wedge-shaped filler 48 .
- the wedge-shaped filler is designed to fill a defect (not shown) in the glenoid 41 ( FIG. 5 ) and to couple the base 12 and offset to the glenoid 41 .
- the wedge-shaped fill 48 includes a locking mechanism 50 .
- the locking mechanism 50 is a ball-shaped member 52 .
- the ball-shaped member 52 is the same size as the ball-shaped member 38 of the anchor peg 32 and cemented pegs 34 .
- FIGS. 8-10 Another component of the present invention is illustrated in FIGS. 8-10 .
- the base 12 is coupled to an offset and a plurality of glenoid attachment members 16 .
- the glenoid attachment members 16 are augments 54 .
- the augments 54 are designed to fill defects in the glenoid 41 .
- the augments 54 may be of different heights, allowing the surgeon to fill different sizes of defects within the glenoid.
- Each of the augments 54 includes a locking mechanism 56 designed to fit within the connection feature 22 of the base 12 .
- the locking mechanism 56 of each of the augments 54 is a ball-shaped member 58 that fits into the generally spherical recesses 40 of the base 12 .
- the ball-shaped member 58 be of the same size as the ball-shaped members 38 , 52 of the pegs 32 , 34 , and wedge-shaped filler 48 allows the user to use a single base 12 with multiple components, depending upon the needs of the patient.
- FIG. 8 two differently sized augments 54 are coupled to the base.
- the user could select more augments 54 as shown in FIG. 9 .
- FIGS. 8 and 9 are merely examples, any number of augments 54 may be used depending upon the defect to be corrected.
- the kit 60 includes a base 12 , a plurality of offsets 14 a , 14 b , 14 c , and a plurality of glenoid attachment members 16 a , 16 b , 16 c , 16 d .
- each of the plurality of offsets 14 a , 14 b , 14 c has a different height h a , h b , h c .
- the offsets 14 a , 14 b , 14 c allow the user (in this case a surgeon or other operating room personnel) to select an offset that will best restore ligament and/or tendon tension to the joint.
- the differing sizes of offsets allows the user to lateralize the humerus depending upon the patient. The user may choose to lateralize the humerus more in order to tighten the rotator cuff. Differing numbers of offsets 14 may be included.
- the plurality of glenoid attachment members 16 include a plurality of cemented pegs 34 , a finned anchor peg 32 , a wedge-shaped filler 48 , and a plurality of augments 54 . In other embodiments, other numbers of each of the glenoid attachment members 16 may be included. Also, in some embodiments, some of the attachment members 16 may not be included. In other embodiments, there may be other glenoid attachment members 16 such as pins, screws, nails, un-finned anchor pegs.
- the plurality of different types of glenoid attachment members 16 allows the user (such as a surgeon) to select the type of glenoid attachment member 16 that bests suits the individual patient. For example, if the patient's glenoid is relatively healthy, the surgeon may use only the finned anchor peg 32 and one or more cemented pegs 34 . If there is slightly worse wear, the surgeon may use one or more of the augments 54 . In some embodiments, the augments 54 may be used in conjunction with anchor pegs 32 and/or cemented pegs 34 . Any number and combination of augments 54 may be used to best fit the patient's needs. In cases where the patient has experience sever wear and deterioration of the glenoid, the wedge-shaped filler 48 may be used.
- kits 60 as illustrated other than the ability to mix and match are that each of the glenoid attachment members 16 has the same locking mechanism and that the connection features 22 are all sized and shaped the same. This allows the user to place the attachment members 16 into any of the connection features 22 , depending on the patient's anatomy.
- the base 12 , offsets 14 , and glenoid attachment members 16 are all made of ultra-high molecular weight polyethylene. In other embodiments, the base 12 , offsets 14 , and glenoid attachment members may be manufactured using biocompatible metals or other biocompatible plastics. Alternatively, it is also contemplated that the base 12 , offsets 14 , and glenoid attachment members 16 may not all be manufactured using the same materials.
- the method includes using the base 12 and a plurality of attachment members 16 .
- the base 12 has a first side 18 and an opposing second side 20 .
- the second side 20 includes a plurality of connection features 22 .
- Each of the plurality of attachment members 16 includes a locking mechanism 36 .
- one of the plurality of glenoid attachment members 16 is selected.
- the base 12 is then connected to the selected one of the plurality of glenoid attachment members 16 by connecting the locking mechanism 36 of the selected one of the plurality of glenoid attachment members 16 to one of the plurality of connection features 22 of the base 12 (step s 106 ).
- the plurality of glenoid attachment members 16 may include finned anchor pegs 32 , cemented pegs 34 , wedge-shaped fillers 48 , and augments 54 and the locking mechanism 36 of each of the plurality of glenoid attachment members 16 is the same, so that any of the glenoid attachment features 16 may be locked into the base 12 .
- the user may decide to insert the selected attachment member 16 first into the drilled glenoid 41 .
- the user will then lock the base 12 onto the selected attachment member 16 .
- the user may pre-assemble the base 12 and the selected attachment member 16 prior to inserting the implant 10 into the glenoid 41 .
- the method may further include using a plurality of offsets 14 and selecting one of the plurality of offsets 14 .
- the selected offset 14 is then connected to the base 12 as described above in reference to FIGS. 1-5 .
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- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Cardiology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Vascular Medicine (AREA)
- Life Sciences & Earth Sciences (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Prostheses (AREA)
Priority Applications (4)
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EP11788320.7A EP2642951B1 (fr) | 2010-11-24 | 2011-11-18 | Prothèse glénoïde modulaire |
PCT/US2011/061347 WO2012071260A1 (fr) | 2010-11-24 | 2011-11-18 | Prothèse glénoïde modulaire |
US13/911,120 US8961611B2 (en) | 2010-11-24 | 2013-06-06 | Modular glenoid prosthesis |
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US13/911,120 Division US8961611B2 (en) | 2010-11-24 | 2013-06-06 | Modular glenoid prosthesis |
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US (2) | US8480750B2 (fr) |
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Also Published As
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US20120130499A1 (en) | 2012-05-24 |
US8961611B2 (en) | 2015-02-24 |
EP2642951A1 (fr) | 2013-10-02 |
EP2642951B1 (fr) | 2016-11-02 |
US20130333187A1 (en) | 2013-12-19 |
WO2012071260A1 (fr) | 2012-05-31 |
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